Charge Comparison - Facility CareScience

This analysis enables you to evaluate the Charge outcomes for a defined population. Use this analysis to identify the top APR DRGs or MS-DRGs with opportunity for improvement.

Select Population Tab:

There are 3 required prompts that you must select before running this analysis.

Required Prompts:

  • Facilities
  • Time (1 year is selected by default.)
  • Inpatient/Outpatient (Inpatient is selected by default. You should not select Outpatient for this analysis because risk-adjusted metrics are calculated for inpatients only.)

Optional Prompts:

  • Diagnoses (ICD-10)
  • Procedures (ICD-10)
  • Inlier/Outlier
  • Patient Types
  • Patient Demographics
  • Patient Origination
  • Patient
  • Practitioners
  • Patient Visits
  • Resources - SPL
  • Facility Payers
  • Standard Primary Payers
  • Standard Secondary Payers
  • Patient Qualifications

Set Up Analysis Tab:

Row Header Prompt

  • MS-DRG is selected by default. However, you can select any attribute(s) you want.

Expected Values on CareScience Analyses

CareScience analyses have two risk-calculation modes for the Expected value: Standard Practice and Select Practice. However, for Charge, only Standard Practice Expected values are calculated. Standard Practice is the only option available in the Page-By.

For more information, see Standard and Select Practice.

Default Metrics

The following metrics appear in the grid when the analysis returns:

  • Total Cases - All cases that qualified for the analysis.
  • Outcome Cases - The number of cases for the Charge/Case outcome that qualified for risk adjustment. Based on the Outcome Case methodology, some cases may not qualify for risk adjustment.
  • Geometric Observed - The charge/case for the Charge Outcome Cases.
  • Geometric Expected - The expected value for the Outcome Cases, calculated using the CareScience Analytics risk-adjustment methodology and the geometric mean.
  • Geometric Variation - The Observed value minus the Expected value.
  • Geometric SS - Asterisks display only if the Variation is statistically significant. The number of asterisks indicates the confidence level that the outcome's variation is not due to chance: 1 asterisk = 75%, 2 asterisks = 95%, 3 asterisks = 99%. Green asterisks = the outcome’s variance is statistically better than expected. Red asterisks = the outcome’s variance is statistically worse than expected. Total lines do not have values for Statistical Significance.
  • Geometric O/E - The Observed value divided by the Expected value. Less than 1 = performing better than expected. Greater than 1 = performing worse than expected.
  • Opportunity (Geo Charge) - The calculation of the Variation multiplied by Charge/Case Outcome Cases. There must be at least one charge opportunity dollar for a value to display. Charge opportunities are rounded to the nearest dollar.

For more information, see Metrics on the Risk-Adjusted Analyses.

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Metrics in Report Objects

Report Objects allows you to add metrics to the grid. Click the button in the Tools toolbar to see the metrics in Report Objects. You can drag-and-drop the following metrics on the grid for this analysis:

  • CMS HAC Cases After Admit - The number of patients with at least one CMS Hospital Acquired Condition (HAC) after admission.
  • Arithmetic Expected - The expected value for the Outcome Cases, calculated using the 3M™ risk-adjustment methodology and the geometric mean.
  • Arithmetic O/E - The Observed value divided by the Expected value. Less than 1 = performing better than expected. Greater than 1 = performing worse than expected.
  • Arithmetic Observed - The charge/case for the Charge Outcome Cases.
  • Arithmetic SS - Asterisks display only if the Variation is statistically significant. The number of asterisks indicates the confidence level that the outcome's variation is not due to chance: 1 asterisk = 75%, 2 asterisks = 95%, 3 asterisks = 99%. Green asterisks = the outcome’s variance is statistically better than expected. Red asterisks = the outcome’s variance is statistically worse than expected. Total lines do not have values for Statistical Significance.
  • Arithmetic Variation - The Observed value minus the Expected value.
  • Opportunity (Arith Charge) - The calculation of the Variation multiplied by Charge/Case Outcome Cases. There must be at least one charge opportunity dollar for a value to display. Charge opportunities are rounded to the nearest dollar.
  • Total Charges - The total charges for the Charge/Case Total Cases.
  • Total Charges for Outcome Cases - The total charges for the Charge/Case Outcome Cases.

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Analysis Sample

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Drilling to Patient Details

Facility All Patient Detail Analysis

This analysis allows you to drill to the Facility All Patient Detail Analysis, which includes all the patients that match the criteria entered at the prompts.

To access this drilldown, right-click on the column header or the rows and select Drill > Drill to Patient Detail Analysis > Facility All Patient Detail Analysis.

For more details, see Facility All Patient Detail Analysis.

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